Psychiatry
Bipolar Disorder Management
NICE NG185 — distinguish acute mania / depression / mixed / euthymia, mood stabilisers, address psychosocial.
Source: NICE NG185 (2014, updated 2023)
Used in: Depression & Anxiety
Step 1 of ~5
info
Diagnostic Distinction
Bipolar I: ≥1 manic episode (often with depression). Bipolar II: hypomanic + depressive episodes (no full mania). Cyclothymia: chronic, less severe oscillations.
Mania/hypomania: elevated/irritable mood + ≥3 of (4 if irritable) inflated self-esteem, ↓ sleep, talkativeness, flight of ideas, distractibility, ↑ goal-directed activity, risk-taking. Mania ≥7 days OR hospitalisation OR psychosis. Hypomania ≥4 days, no severe impairment.
Exclude: substance use, hyperthyroidism, steroid effect, frontal lobe lesion, schizoaffective disorder.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Lamotrigine (Psychiatric Use) · Mood Stabiliser (Sodium Channel Blocker) — Bipolar Depression
- Carbamazepine (Psychiatric Use) · Mood Stabiliser (Sodium Channel Blocker) — Bipolar Disorder
- Carbamazepine (Paediatric) · Antiepileptic — Focal Seizures / Trigeminal Neuralgia / Bipolar Disorder
- Esketamine · NMDA Receptor Antagonist (Treatment-Resistant Depression / Acute Suicidality)
- Lumateperone · Atypical Antipsychotic — Multimodal (Schizophrenia / Bipolar Depression)
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185
Decision support only. Always apply local guidelines and clinical judgement.